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Therapeutic plasma exchange to slow cognitive decline in Alzheimer’s disease

Therapeutic plasma exchange (TPE) is used to treat a variety of neurological, immunological, and metabolic disorders. The procedure removes patient plasma to eliminate pathological constituents such as antibodies, immune complexes, and protein-bound toxins. TPE’s capacity to remove pathological factors led to interest in its use in Alzheimer’s disease, where the accumulation of extracellular amyloid-β (Aβ) as diffuse and neuritic plaques is recognized as one of the defining pathologies associated with the disease.

Assuming dynamic equilibrium of Aβ between the plasma and cerebral spinal fluid (CSF), TPE with albumin replacement in Alzheimer’s is based on the rationale that peripheral sequestration of Aβ and routine elimination of albumin bound Aβ would modify the equilibrium, drawing Aβ out of the CSF into the plasma.

In this episode, dementia specialists Mercè Boada, MD, PhD, Fundació ACE, International University of Catalonia, Barcelona, Spain; Javier Olazarán, MD, PhD, Gregorio Marañón Hospital, Madrid, Spain; and Miquel Lozano, MD, PhD, Hospital Clínic de Barcelona, Barcelona, Spain, discuss the use of plasma exchange plus albumin replacement as an innovative treatment for Alzheimer´s disease, from rationale through to Phase III data and clinical implementation.

Date: 3rd February 2022